Individual provider Active NPI

Ricky Lee Behncke, DC

  • Chiropractor
  • Janesville, WI
National Provider Identifier
1437222072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1472 Issued in WI
Practice address
409 E Milwaukee St
Janesville, WI 53545-3186
Phone
(608) 754-3192
Fax
(608) 754-3256
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1472 WI Primary

Addresses

Primary practice location

409 E Milwaukee St
Janesville, WI 53545-3186

Mailing address

409 E Milwaukee St
Janesville, WI 53545-3186
Phone (608) 754-3192

Other identifiers 2

IdentifierTypeStateIssuer
12031OtherWIDEAN HEALTH PLAN
38761700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071115000626 WI Practitioner - Chiropractic 4082702527

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

409 E Milwaukee St
Janesville, WI 53545-3184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas & Mork Chiropractic S C Chiropractor CurrentSince Jul 1, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437222072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453186",
            "telephone_number": "608-754-3192",
            "fax_number": "608-754-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E MILWAUKEE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453186",
            "telephone_number": "608-754-3192",
            "fax_number": "608-754-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHNCKE",
        "first_name": "RICKY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "12031",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38761700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.